Page 18 - The Beauty and Sorrow in Endodontics-Prologue

(Fig 6E) (Fig 6F)
6-weeks post-op of 44 treatment Crowns have been cemented and
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shows reduced lesion around 44 and complete healing observed around
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reformation of lamina dura around both 43 and 44.
# 43.

This patient is the 80-year-old grandmother of a dental student. She reported no
discomfort after her grandson completed a root canal treatment for her on 43, however,
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upon careful examination of the post-operative radiograph, the student noticed some
widening of the PDL at the mesial apical third of 43 without a sealed lateral canal that
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possibly exists (Fig 6A). He decided to remove the gutta percha and complete retreatment

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following the principles of Schilderian Endodontics. After proper retreatment of 43, a
sealed lateral canal can now be seen at the suspected location (Fig 6B). Even at 80 years
old, some healing of the lesion can already be seen at 6-weeks post-treatment, however,
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another radiolucent lesion was noted at the mesial apical third of 44 (Fig 6C). Cavity
testing of 44 confirmed its pulp status as necrotic and was in need of root canal treatment.
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Post-operative radiograph of the completed 43 and 44 root canals reveals lateral canals
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which are found at similar locations on these adjacent teeth (Fig 6D). Post and core were
then completed on these teeth and continued follow-ups show gradual healing of both

lesions (Fig 6E, 6F). Therefore, it can be concluded that healing of any lesions of
endodontic origin after endodontic treatments are affected more by the patient’s immune
system and not his or her age. If the patient has an impaired immune system, there would
be impaired healing process regardless of the type of treatment rendered. On the other

hand, with a healthy immune system, the age of the patient and the operator’s experience
become less significant, and as long as proper treatment has been performed, healing can
be expected.

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